Self-Management: Great in Theory, Flawed in Practice

Oct 9
Every guideline for chronic pain care emphasizes the importance of patient self-management. Cognitive-behavioral tools, pacing, sleep hygiene, stress reduction, gentle movement — they're all evidence-based.

But here's the catch: who actually teaches patients how to do these things?

Most patients turn back to their physician. 

 Most patients turn back to their physician. Yet the truth is:
  • Few of them were trained in how to coach self-management behaviors.
  • Medical curricula still focus on diagnosis + pharmacology, not behavior change science.
  • "Just exercise more" or "try to manage your stress" isn't enough to build durable skills.

The U.S. Pain Foundation's Living Well With Chronic Pain – An Educational Guide makes this gap explicit: patients are asked to self-manage without adequate instruction or support. (uspainfoundation.org)

What This Means for Clinicians
  1. Patients need structured teaching — Self-management isn't intuitive. Without guidance, adherence falls and frustration rises.
  2. Physicians can't do it all — Their visit lengths are too short, and behavior-change training isn't one of their core competencies.
  3. Interdisciplinary models work — Health coaches, navigators, PTs, behavioral specialists, and integrative providers can reinforce skills between visits.

How Anodunos Fits In
At Anodunos, we're not trying to provide education for physicians in a holistic approach to chronic pain. Instead, we:
  • Train Pain Navigators to deliver structured self-management coaching, pacing, and troubleshooting.
  • Equip providers with an integrative framework and communication tools that make it easier to reinforce patient strategies in the clinic.
  • Build coordinated networks where physicians aren't alone — but instead supported by a team that aligns with HHS pain management guidelines and whole-person care.

That means physicians can focus on diagnosis, medical management, and clinical judgment — while knowing their patients are getting the ongoing skills training they need to live better with pain.

Why It Matters
  • Clinical efficiency: You don't burn visit time re-explaining coping strategies.
  • Better outcomes: Patients gain confidence, reduce reliance on crisis care, and use medications more appropriately.
  • Professional alignment: Fits squarely with value-based models and payer incentives for reducing unnecessary utilization.

Call to Action
If you're a clinician who feels stuck between telling patients to "self-manage" and watching them struggle actually to do it, you're not alone. We need to build systems that teach and support self-management, rather than just prescribing it.
That's precisely what Anodunos is working to scale. Let's make the guidelines actionable—together. 
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